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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Stress Incontinence in Women
What is stress incontinence?
A lack of bladder control is known as urinary incontinence.
It is an embarrassment for as many as one in three Americans
age 60 or older and is twice as common in women as men.
Stress incontinence is the most common kind of urinary
incontinence in women. It is the term used for leakage of
urine during exercise, coughing, sneezing, laughing, or
lifting.
What causes stress incontinence?
The pelvic floor muscles normally fit snugly around the neck
of the bladder. They form a ring of muscle that prevents
urine from escaping through the urethra, which is the tube
that carries urine from the bladder. However, the pelvic
floor muscles can be stretched or torn during childbearing.
There may also be further loss of muscle tone after
menopause due to a thinning of tissues caused by a lack of
estrogen. Sudden pressure on the bladder (for example, from
coughing or sneezing) can overcome the weakened muscles and
cause a little urine to escape. Diabetes, obesity, and
urinary tract infections also contribute to stress
incontinence.
What are the symptoms?
Symptoms include leakage of urine during exercise, laughing,
coughing, sneezing, or lifting.
How is it diagnosed?
Your health care provider will take a careful history and
examine you to see if the incontinence is caused by an
underlying condition that can be corrected. Your blood and
urine will be checked for infection or other abnormalities.
You may be referred to a urologist or gynecologist for
further investigation and treatment. (A urologist is a
doctor who specializes in disorders of the urinary tract in
both men and women and in the reproductive tract of men. A
gynecologist specializes in women's health care and
especially in disorders of the reproductive tract of women.)
How is it treated?
Weak pelvic muscles can often be strengthened by Kegel
exercises. The next time you use the bathroom, try to stop
the flow of urine. The muscles used to stop the flow are
the same muscles that need to be strengthened. One of
the ways to do Kegel exercises is to tighten these muscles
for a count of four and then relax them. Repeat this
tightening 10 to 20 times. (You may want to check with your
health care provider to make sure you are doing the exercise
correctly.) If you do the Kegel exercise several times
faithfully each day, you should see improvement in about
2 months. Vaginal muscle tone will improve at the same
time, which may make you more sexually responsive.
Some medications can help tighten the ring of muscles that
control release of urine. Estrogen therapy may be
prescribed to increase circulation, tone, and urethral
muscle response in postmenopausal women.
The pelvic muscles may also be tightened by surgery.
Your health care provider may prescribe a pessary, which is
a device similar to the outer ring of a diaphragm. A
pessary is inserted into the vagina. It gives support to the
pelvic structures and may help to prevent stress
incontinence. Your health care provider may advise using a
pessary to support lax pelvic muscles if this is
contributing to the incontinence.
If medical or surgical treatment does not help or is not
available, you can buy incontinence pads at the grocery or
drug store. They are available in all sizes and degrees of
absorbency, but they are expensive.
How can I take care of myself?
- Consult your health care provider if you begin to have
urinary incontinence. Follow his or her advice for
correcting or managing your incontinence.
- Practice bladder control. Do Kegel exercises regularly.
- Use incontinence pads if you need to. Be sure to change
them regularly.
- Keep your groin area as clean and as dry as possible.
For more information, call or write:
National Association for Continence
P.O. Box 8310
Spartanburg, SC 29305
800-BLADDER (252-3337)
Web site: http://www.nafc.org
Education, advocacy, and support to the public and health
professionals about the causes, prevention, diagnosis,
treatment, and management alternatives for incontinence
The Simon Foundation for Continence
P.O. Box 835
Wilmette, IL 60091
800-23SIMON (237-4666)
Web site: http://www.simonfoundation.org
Information on incontinence in books, on tape, and via
newsletter
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